New Mental Health Regional Framework

The new WHO Report- 20 years on

More attention needed for mental health and social care

Creating Futures 2021

No Health Without Mental Health: Integrating wellness and recovery

Clinical Education Online: Creative programs emerging from travel constraints

Suicide risk and prevention during the COVID-19 pandemic

Guide to living with worry and anxiety amidst global uncertainty

Mental Health and Behavioral Guidelines for Preparedness and Response to Coronavirus

Timely mental health care is urgently needed

WHO has published the Regional Framework for the future of mental health in the Western Pacific 2023-2030 in June.

The Framework overall aims are to promote the highest level of mental health for all people in the Region, and was  endorsed by the Regional Committee for the Western Pacific in October 2022.

Envisioned to support Member States in designing national strategies, plans, and policies on mental health, the Framework also looks to strengthen political advocacy for greater resources and commitment, and to encourage coordination and collaboration among partners in order to build back better and fairer, creating mental health systems that are more resilient for the future.  The framework acknowledges that good mental health is integral to the well-being of everyone, and that promoting and protecting mental health is also critical to a well-functioning society.

In the Framework, WHO writes that the Western Pacific Region has seen profound effects of the coronavirus disease (COVID-19) pandemic on day to day life.  This can create momentum for profound changes to the way that health services support mental health and well-being. To support all people, WHO urged all WHO Member States to use the Regional Framework as a guide to Refocus, Transform and Embed.

WHO outlined three directional strategies to describe the way forward for the mental health agenda in the Western Pacific Region;

  • Refocus the mental health agenda to include well-being and reaching the unreached through leadership that champions mental health in all policies, and strategies generated from the grounds up that match solutions to the voiced needs of communities, supported by strategic communication and advocacy.
  • Transform mental health support and care into a community-based ecosystem of health and social services and innovations, enabled by an expanded and well-trained mental health workforce comprising specialists, non-specialists and social networks, delivering the full range of interventions, and underpinned by a responsive information system that drives impact.
  • Embed mental health into the settings and journeys of daily life by engaging and empowering communities with tools and platforms that enhance protective factors and reduce risk factors across the life course, and by fostering social interventions and partnerships with co-benefits for mental health and other social sectors.

The Framework is now available online here https://www.who.int/westernpacific/publications-detail/9789290620075

Figure 6 A systems approach to mental healthframework cover

Calls for changes to attitudes, actions and approaches to mental health.

WHO will officially launch the World Mental Health Report 2022 online and invites all stakeholders to join on Friday 17 June, 2022, 2pm Central European Time.

The detailed work provides a blueprint for governments, academics, health professionals, civil society and others with an ambition to support the world in transforming mental health.

In the document, the benefits of change are outlined, showing that committing to mental health is an investment into a better life and future for all.  Investing in mental health means investing in strategies to: ensure access to effective, quality, affordable mental health care for all; tackle stigma, discrimination and abuse; and address underlying social and economic realities that shape people’s mental health.

The report reiterates that there is a core set of cost–effective interventions for priority mental health interventions that are feasible, affordable and appropriate.  Digital technologies can strengthen mental health systems by providing tools to inform and educate the public, train and support health care workers, deliver remote care, and enable self- help.

Importantly, the report focuses on people with lived experience, who are important agents of change in increasing awareness and acceptance of mental health conditions among the general public.  Community-based mental health care is more accessible and acceptable than institutional care, helps prevent human rights violations, and delivers better recovery outcomes for people with mental health conditions.

The Official Launch will be held on June 17.   14:00 – 15:30 Central European Time

Register: https://who.zoom.us/webinar/register/WN_be9aDv1_QuiigKtX004OqQ

If this time zone means you are not able to attend live, the launch will be later available as an online recording with the report.

 

Social benefits

As we celebrate Mental Health Month, Professor Chee Ng spoke with English language Asian news network CAN about some of the regional impacts of COVID-19 and social restrictions.

Healthscope Professor of Psychiatry, University of Melbourne and Director WHO Collaborating Centre in Mental Health, Professor Ng reiterated long standing calls for increasing resources and addressing service development needs.

“We need to ensure that a mental health response is well integrated to any COVID response so that mental health and social care can be provided to COVID survivors, contacts, close family members, frontline workers as well as the broader communities”

To watch go to the CNA link:

Oct 2021 – Asia First – Fri 8 Oct 2021 – meWATCH

 

2021 CNA interview Oct

The 8th conference for Creating Futures is online from 21-22 July 2021. With central sites at Fiji, Vanuatu, Samoa, FSM, Kiribati, PNG, Tonga and Solomon Islands, CF21 is an exciting new model of online engagement for the region.

Over eighteen years Creating Futures has evolved from a conference to a movement that seeks to harness experience, expertise, innovation and goodwill to build the capacities necessary to improve the mental health status of disadvantaged populations in Australasia and the Western Pacific. It exists as an independent, task-focused collaboration of individuals and institutions built on a foundation of relationships of trust across time, terrain, sectors and special interests.

St. Vincent’s Mental Health is proud to be a CF21 partner and to contribute to the resources and expertise that the Creating Futures movement offers.  This movement to address the shortage and inequitable distribution of specialist resources is especially important for mental health services facing rising demands and complexities in 2021.

The conference is free to attend and further information and registration can be found here: https://creatingfutures.org.au/

 

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Book of Proceedings for the 1st Asia Pacific Symposium of Optimal Health Program.  This event was held on 15 October 2019 in Putrajaya, featuring expertise from Malaysia, Indonesia, China and Australia.

The symposium was a platform that brought together health professionals and consumers to discuss Optimal Health Program (OHP) service development and research in the Asia Pacific region. OHP champions from Australia, Malaysia, Indonesia and China shared valuable presentations, as well as insights through discussions and poster sessions, focusing on integrating wellness and recovery concepts in healthcare.

The 2021 Ophelia Training will conclude on Wednesday 30 June, with over 100 Pacific Island health workers over the last 12 weeks attending the sessions online, and learning together about the mental health issues that affect children and young people.  Ophelia- which stands for Online Pacific Health Exchange- is a short course in delivering child and adolescent mental health services, with a structure that allows interdisciplinary networking and a focus on sharing best practices and evidenced based health care.

As a response to travel restrictions, Ophelia was first piloted in 2020, St. Vincent’s Mental Health, Royal Australia and New Zealand College of Psychiatrists Faculty of Child and Adolescent Psychiatrists, and the Fiji National University, College of Medicine, Nursing and Health Sciences.  The partners have expanded the course for 2021, now featuring;

  • 12 weeks of 60 minute online sessions, focusing on practice examples and sharing interdisciplinary experiences.
  • A structured approach to learning via reflective practices and peer exchanges.
  • Access and support for training materials and other foundational education resources

The participants in the 2021 group have gathered from a wider range of health settings, and bring varying levels of experience.  With an expanding technological capacity in the Pacific generally, the participants are from major centres and rural health settings in Fiji, Solomon Islands, Cook Islands, Papua New Guinea, Kiribati, Vanuatu, Marshall Islands.  Some are accessing the training with their first few years of working in mental health, others have more than 15 years experience.

Thank you for this session. I am sitting and listening and realised that I have come a long way.”(Ophelia Participant)

At times, the technology has created difficulties, but the group are growing in confidence and capacity, as well as persistence.  Being able to record the didactic sections of the presentation, and sharing the resources after the sessions has been helpful, although not as good as being able to talk with each other.

 “Thank you everybody ,really enjoyed the session but my connectivity was a bother. However, I did sit and listen to the presentation…till the end.  See you all next week.  Moce.” (2021 Ophelia Participant)

“Thank you so much! This was so great and informational. Vinaka!” (2021 Ophelia Participant)

Accessing specialist mental health studies in our region can be difficult, and the WHO country guide for Adolescent Health notes that adolescent mental health and well-being are often overlooked.  More than half the group reported that they had not had formal studies in working with children and young people, including within specialist mental health studies.

“Thank you so much for this important topic and yes staff are the most important resource in a work place.” (2021 Ophelia Participant

 “It would be great to learn more in depth as well if we could have time to understand and being trained on how to use any particular assessment tool so that we could use it in our clinical practice.” (2021 Ophelia Participant)

With a young demographic in our region and with adolescences as the foundational period in the lives of individuals and for the health of our community, it is crucial that health workers will have a good understanding of children and young people’s health and well being.  Additionally, with the majority of mental health providers providing services for the whole population, there is even more motivation for prevention, early detection and treatment of problems, and the opportunity to set a pattern of healthy lifestyles and reduce morbidity, disability and premature mortality later in adulthood.

This program builds on the collaboration between St. Vincent’s, Fiji University’s College of Medicine, Nursing and Health Sciences, and RANZCP’s Faculty of Child and Adolescent Psychiatrists.  Further workshops are planned with a strong commitment from these 3 organisations to training and education of health professionals in the Pacific region.

 

2021 Ophelia Training Vinesh                  2021 Ophelia Training Sandra

RANZCP presenters during 2021 Ophelia Training sessions

While the current context is different and evolving, previous experiences with pandemics will indicate that preventing suicide needs urgent consideration within the COVID-19 Response.

The Lancet reportsthat suicide is likely to become a more pressing concern as the pandemic spreads and has longer-term effects on the general population.   (https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30171-1/fulltext)

The article gathers public health responses to mitigating suicide risks, including:

  • Selective and indicated interventions for individuals who are at heightened risk of suicide or are actively suicidal; designed to reduce risk of suicide among these individuals
  • Universal interventions for the whole population and focus on particular risk factors without identifying specific individuals with those risk factors; designed to improve mental health and reduce suicide risk across the population

The article calls for continuing research and international collaboration especially drawing on the experience of national strategies to provide a strong basis for suicide prevention.

Psychology Tools have put together a free online guide called “Living with worry and anxiety amidst global uncertainty.”  https://www.psychologytools.com/articles/free-guide-to-living-with-worry-and-anxiety-amidst-global-uncertainty/

Psychology Tools’ is a UK online resource for English speaking communities.  The aim is for therapists worldwide have access to the high-quality evidence-based tools they need to conduct effective therapy, and to be a reliable source of psychological self-help for the public.

“Everyone worries to some degree, and some thinking ahead can help us to plan and cope. There is no ‘right’ amount of worry. We say that worry becomes a problem when it stops you from living the life you want to live, or if it leaves you feeling demoralised and exhausted.”

This resource provides evidence based psychoeducation about normal and excessive worry, lots of normalization, and a selection of practical exercises that you, your clients, or anyone can use to manage worry and maintain well-being in these uncertain times.

The guide has practical strategies for maintaining balance in your life, speaking to yourself with compassion as well as noticing and limiting worry triggers

Mental Health and Behavioral Guidelines for Preparedness and Response to Coronavirus

The USA Center for the Study of Traumatic Stress is rapidly developing a range of resources that can be found here: https://www.cstsonline.org/resources/resource-master-list/coronavirus-and-emerging-infectious-disease-outbreaks-response

 

It is vital to keep in mind that effective public mental health measures will address numerous areas of potential distress, health risk behaviors, and psychiatric disease.

 

Areas of special attention include:

(1) the role of risk communication;

(2) the role of safety communication through public/private collaboration;

(3) psychological, emotional, and behavioural responses to public education, public health surveillance and early detection efforts;

(4) psychological responses to community containment strategies (quarantine, movement restrictions, school/work/other community closures);

(5) health care service surge and continuity; and

(6) responses to mass prophylaxis strategies using vaccines and antiviral medication.

 

Read more about the Mental Health Behavioral Guidelines Reponse to Coronavirus Outbreaks here:  https://www.cstsonline.org/assets/media/documents/CSTS_FS_Mental_Health_Behavioral_Guidelines_Response_to_Coronavirus_Outbreaks.pdf.pdf

 

In a recently article with Lancet Psychiatry, mental health professionals from China, Hong Kong and Australia reflected on some practical strategies for timely mental health care for the 2019 novel coronavirous outbreak.

 

Read the full article here: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30046-8/fulltext

 

In any biological disaster, themes of fear, uncertainty, and stigmatisation are common and may act as barriers to appropriate medical and mental health interventions.  The key methods of developing urgent mental health capacity in the system were summarised as:

 

  1. First, multidisciplinary mental health teams established by health authorities at regional and national levels (including psychiatrists, psychiatric nurses, clinical psychologists, and other mental health workers) should deliver mental health support to patients and health workers.  Specialised psychiatric treatments and appropriate mental health services and facilities should be provided for patients with comorbid mental disorders
  2. Second, clear communication with regular and accurate updates about the 2019-nCoV  outbreak should be provided to both health workers and patients in order to address their sense of uncertainty and fear. Treatment plans, progress reports, and health status updates should be given to both patients and their families.
  3. Third, secure services should be set up to provide psychological counselling using electronic devices and applications (such as smartphones and WeChat) for affected patients, as well as their families and members of the public. Using safe communication channels between patients and families, such as smartphone communication and WeChat, should be encouraged to decrease isolation.
  4. Fourth, suspected and diagnosed patients with 2019-nCoV pneumonia as well as health professionals working in hospitals caring for infected patients should receive regular clinical screening for depression, anxiety, and suicidality by mental health workers. Timely psychiatric treatments should be provided for those presenting with more severe mental health problems.

 

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